Member of Public Staff Membership Form

Member of Public Library Membership Application Form
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City County

Postcode
Home Phone Number *

Area Code Phone Number
Mobile Phone Number

Code Phone Number
Email *
example@example.com
Upload a passport style photograph *
Upload a letter detailing why you require access to the library *
I agree to treat all library property with due care and respect *
I understand that in the event of loss or damage to items borrowed from the Library, I will be responsible for meeting any repair or replacement costs incurred *
I agree to abide by the rules and regulations of the library *
I agree to pay the membership fee of £25.00 per annum, plus an admin fee of £25.00 if applicable (admin fee not applicable if renewing) *
Signature *

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Member of Public Library Membership Application Form